A Topeka birth doula is launching a nonprofit to serve teenage moms, pregnant women who are incarcerated and low-income single moms — underserved groups that may not even be aware of the doula option, she said.

Juliet Swedlund began working as a doula in Seattle, she said, where a doula assisting in childbirth is more common. Her family moved to Topeka three years ago, and she said she knows of about 10 doulas who work in Topeka, Lawrence and the surrounding area.

A doula provides nonmedical assistance to a woman during birth, offering physical, emotional and informational support. They might suggest position changes or massage techniques, or help the woman’s partner be better involved.

But doula care isn’t covered by Medicaid or by most insurance in Kansas, Swedlund said.

"So most of the women you will find who are getting a doula are middle-income white women," she said. "But there are whole populations of people who are missing out on this service because of fees or because of cultural norms and even awareness that this is an option."

Swedlund hopes to reach out to some of those groups through the Topeka Doula Project, a nonprofit she is working to launch. She plans to work with the Washburn Law Clinic to set it up as a 501(c)(3) so she can start applying for grant funding and will draw on her background in fundraising campaigns while working at the Seattle YMCA to raise operating funds. She is working to establish partnerships and spread the word about the services she offers.

"As a birth doula, your primary goal is to empower women to have a positive birth experience, to feel informed about their options and to assist them with the birth they hope to have," no matter what that looks like, she said.

Women in the groups Swedlund’s nonprofit focuses on often don’t have much support during their pregnancy or may even be ambivalent about it, she said. Pregnancy may not be a happy, special time for a woman who is incarcerated or for a teen mom struggling with what being a mom will look like for her.

"A doula can help them process that transition and help them navigate the emotions that they’re feeling to have the most positive birth experience," she said, "that they come out of the birth feeling stronger, feeling empowered and just feeling like they had control over what was happening."

Because there is no regulatory certification process for birth doulas, they have varying levels of training or certification. Swedlund is certified by DONA International, which according to its website is the largest doula certifying organization and uses evidence-based training and certification. Certification is an extensive process that can take up to two years, she said. It requires attending at a certain number of births and receiving feedback from obstetricians, midwives or nurses who were present at the
births.

Swedlund hopes eventually to bring other doulas — who also ideally would be certified — into the project as it broadens its scope and reach. As a long-term goal, she said, she wants to become a DONA doula trainer so she can offer mothers for whom she is a doula the chance to go through doula training themselves so they leave the experience with a skill with which they can move forward.

Before becoming a doula, Swedlund worked in health and wellness to help people make healthy lifestyle and behavioral changes. She feels that background was helpful in her training as a doula.

"Mental and emotional health can affect you physically, and especially when you’re having a baby," she said. "It’s such a huge transitional time, and you have so many emotions that pop up from your own childhood and your own relationship with your parents or your mother, and if there’s some ambivalence around having a baby, that can affect the physical process of it."

Swedlund’s hope is to guide the mother through that in a way that makes sense for her. While some women want a doula to help them cope with the pain of childbirth, others may not want to feel that pain. Helping a pregnant woman understand her feelings so she can be at peace with her decision requires Swedlund to set her own biases aside.

"As a doula, you don’t want to superimpose any one set of ideas on what childbirth needs to look like," she said. "You want to help a mother find what she needs her childbirth to look like."

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